ES2653695T3 - Hand orthosis for thumb support, especially in case of rhizarthrosis - Google Patents

Abstract

Hand orthosis for holding the thumb, the orthosis comprising a main piece (1) made of an elastic material and including: a first part (2) in the shape of a cuff fitted to a part of the thumb that extends to the fold area between the thumb and the palm of the hand, a second part (4) shaped like a cuff fitted to the wrist and a third part (3) that joins the first and second parts, configured to wrap an area of the hand that extends along the metacarpal of the thumb between the back and the palm of the hand, and that includes an opening (6) for the passage of the palm of the hand, characterized in that the second part (4) is assembled by a line of seam to take the shape of a sleeve, and the main piece (1) is configured in order not to cover the fold area between the thumb and the palm of the hand and is made of a material that presents, in a direction corresponding to a longitudinal axis of the first part, a Young's modulus comprised between 0.5 MPa and 1 MPa.

Description

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DESCRIPTION

Hand orthosis for thumb support, especially in case of rhizarthrosis

The present invention relates to a thumb orthosis. The present invention is especially aimed at relieving people suffering from rhizarthrosis.

With age, a large number of people suffer from osteoarthritis, in particular, of the joint between the thumb and wrist. This condition, called "rizarthrosis," mainly affects women, and manifests itself with very painful outbreaks. At night, random movements of the thumb can cause pain to the point of depriving sleep. This condition may involve the joint between the trapezium and the metacarpus of the thumb and / or the joint between the scaphoid and the trapezium and the trapezoid. This condition can also result in instability or subluxation of the joint between the trapezius and the metacarpus of the thumb.

Rizarthrosis is usually treated with medications and / or orthopedic accessories. Some of these accessories materialize in the form of rigid orthoses aimed at completely immobilizing the joint in question. Therefore, these orthoses are carried mainly at night. By immobilizing the joint, they suppress pain when the joint suffers a crisis. Likewise, they avoid a certain fatigue of the joint, by preventing involuntary movements.

The main drawback of these orthoses lies in their stiffness, which prevents normal use of the thumb and, in particular, of the essential function of the hand, which is the caliper function. These orthoses also have the disadvantage of having to be custom-made, for example, by thermoforming on the hand.

There are also elastic orthoses also aimed at immobilizing the joint. However, it is also true that the hand clamp function produces a considerable reduction of the efforts in the joint chain between the thumb and the wrist. Thus, the force exerted by the clamp is multiplied by a factor of twelve on the carpal-metacarpal joint. As a consequence, these orthoses must apply a high pressure of containment at the base of the wrist, especially to contain the movements linked to an occasional subluxation of the joint. Therefore, these orthoses also have to be made to measure.

On the other hand, there are orthoses that materialize in the form of a mitten, also made to measure by thermoforming on the hand.

All the orthoses described above have the drawbacks not only of having to be custom-made, but also of covering the crease between the thumb and the palm. As a result, only the interfalang thumb joint is not blocked.

US 6702772 and US 2003/0191421 describe hand orthoses for thumb support as described above.

Document FR 2822371 describes a hand orthosis comprising a main part made of an elastic material and including a first sleeve-shaped part fitted to a part of the thumb that extends to the fold zone between the thumb and the palm of the hand, a second cuff-shaped part fitted to the wrist and a third part that joins the first and second parts, configured to wrap an area of the hand that extends along the metacarpal thumb between the back and the palm of the hand, and that includes an opening for the passage of the palm of the hand.

It is desirable to perform a thumb orthosis suitable to relieve the carpal-metacarpal joint, but without hindering the function of the hand clamp. It is also desirable to perform a thumb orthosis that does not need to be custom-made, but only in some standard sizes, without requiring final adjustment.

Embodiments refer to a hand orthosis for holding the thumb, the orthosis comprising a main part made of an elastic material and including: a first sleeve-shaped part adjusted to a part of the thumb that extends to the area fold between the thumb and the palm of the hand, a second cuff-shaped part adjusted to the wrist and a third part that joins the first and second parts, configured to wrap an area of the hand that extends along the metacarpal of the thumb between the back and the palm of the hand, and that includes an opening for the passage of the palm of the hand. According to the invention, the second part is assembled by means of a seam line to take the form of a sleeve, and the main part is configured in order not to cover the fold zone between the thumb and the palm of the hand and is made of a material that has, in a direction corresponding to a longitudinal axis of the first part, a Young's module between 0.5 MPa and 1 MPa.

According to one embodiment, the first part is configured to cover the joint between the two phalanges of the thumb.

According to one embodiment, the main piece comprises two layers of elastic fabric assembled by gluing.

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According to one embodiment, each of the two layers is made of a fabric comprising between 75 and 85% by weight of polyamide and between 15 and 25% by weight of elastane.

According to one embodiment, each of the two layers has a weight of 155 g / m2 and / or a thickness between 0.5 and 0.7 mm.

According to one embodiment, each of the two layers has an elasticity of 85% to 115% in the direction of the warp and 65% to 95% in the direction of the weft.

According to one embodiment, the orthosis comprises a platelet of a material capable of performing a damping function, the platelet being fixed inside the second and third parts, in an area that covers the joint between the metacarpal of the thumb and the doll

According to one embodiment, the platelet is made of a crosslinked polymer gel.

According to one embodiment, the plate has a thickness between 0.4 and 1 mm.

According to one embodiment, the plate is glued on an elastic fabric covering piece that is assembled with the main piece by means of a seam, so that the platelet is sandwiched between the main piece and the cover piece.

According to one embodiment, the plate is sewn with the cover piece on the main piece.

According to one embodiment, the main piece is adjusted to the hand and thumb to keep the thumb joints in a configuration of the hand in which all the muscles of the hand are relaxed and in the absence of external forces exerting on the thumb joints.

According to one embodiment, the main piece is made of a material that has a thickness between 1 mm and 1.4 mm.

Examples of embodiment of the invention will be described in the following, without limitation, in relation to the attached figures, among which:

Figures 1A, 1B, 1C schematically represent the carpo-metacarpal joints of the thumb, suffering from different conditions that can be relieved by the orthosis according to the invention,

Figure 2 represents the dorsal face of a hand endowed with an orthosis according to an embodiment,

Figure 3 represents a part of the outer face of the orthosis,

Figure 4 represents a part of the internal face of the orthosis in reverse configuration,

Figure 5 represents the inner face of a hand in a placed configuration of singing, relaxed muscles,

Figure 6 represents the inner face of the hand in the configuration presented in Figure 5, provided with the orthosis of Figures 2 to 4,

Figure 7 is a sectional view of a part of the orthosis, according to an embodiment,

Figure 8 represents the shape of a flat part from which the orthosis can be performed, according to an embodiment, and

Figures 9A and 9B are curves as a function of time illustrating the performance of the orthosis.

Figures 1A, 1B, 1C represent the carpo-metacarpal joints of the thumb and index. The carpo-metacarpal joints of the MSA thumb comprise a joint between the MP metacarpus and the TZ trapezoid, and a joint between, on the one hand, the SC scaphoid and, on the other, the TZ trapezoid and the TD trapezoid. The carpo-metacarpal joints of the index comprise an articulation between the index metacarpus MI and the trapezoid TD and a joint between the trapezoid TD and the SC scaphoid. Osteoarthritis can affect one or the other of the MSA joints, indicated by scratches in Figures 1A and 1B. The thumb can also be affected by a subluxation of the MP metacarpus with respect to the TZ trapezium, as illustrated in Figure 1C.

Figures 2 to 4 and 6 represent a thumb orthosis, in accordance with one embodiment, aimed at alleviating people suffering from rhizarthrosis or a subluxation of the thumb metacarpus. Figures 2 and 6 represent the orthosis placed on one hand. Figures 3 and 4 represent, respectively, a part of the outer face and the inner face of the orthosis. The orthosis comprises a main part 1 forming a distal part 2, a proximal part 4 and an intermediate part 3 that joins parts 2 and 4, delimited in figures 2 to 4 by mixed lines of dots and stripes. The cuff-shaped part 2 is configured to cover and hold the thumb, from the crease area between the thumb and the palm of the hand to the interfalang thumb joint. The

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Part 2 may extend, for example, to the proximity of the middle of the distal phalanx of the thumb. Part 4, also in the form of a cuff, is configured to cover a part of the forearm, wrist, carpal-metacarpal joints of the thumb and a proximal part of the metacarpos of the fingers. The intermediate part 3 has an opening 6 that extends between the parts 2 and 3, for the passage of the palm of the hand.

The main piece 1 is made of an elastic material and adjusted to the shape of the hand and thumb to be held, without exerting on it a force of containment too intense, capable of causing pain, particularly in the sensitive area of the MSA carpal-metacarpal joints. The orthosis can be removed in the direction of the end of the fingers and thumb, without considerable effort, especially due to the absence of throttling zones.

According to one embodiment, the forming material of part 1 exhibits a certain stiffness, which is combined with a beam effect conferred by the tubular or semi-tubular shape of a straight curved section of the orthosis. The resulting stiffness of the material and the beam effect makes the orthosis susceptible to support the weight of the thumb without flexing.

According to one embodiment, the forming material of part 1 has a Young's modulus between 0.5 MPa and 1 MPa, for example substantially equal to 0.7 MPa. The beam effect obtained can be characterized by the quadratic moment. This moment is about 3000 mm4 for the thumb sleeve 2, and about half for the intermediate part 3.

The ability of the orthosis to support the weight of the thumb is illustrated by Figures 5 and 6. Figures 5 and 6 represent the inner face of a hand placed on a horizontal plane, the muscles of the hand being relaxed. The axes of the forearm, thumb metacarpus and proximal phalanx of the thumb are respectively indicated by segments [A, B], [B, C] and [C, D]. The carpo-metacarpal joints MSA and metacarpo-falangiana of the thumb are indicated by points B and C. In the configuration of the hand shown in Figure 5, it is shown that joints B and C are flexed due to the effect of the weight of the thumb. Thus, the thumb is substantially below the level of the index of the hand in Figure 5. In Figure 6, the hand is in the same configuration as in Figure 5, but is equipped with the orthosis. Figure 6 shows that the thumb is at a level above the index of the hand. According to the configuration of segments [B, C] and [C, D] of Figure 5, reproduced in dotted lines in Figure 6, the angle ABC is revealed slightly smaller in Figure 6 than in Figure 5 The angle BCD is revealed to be significantly larger (in about twenty degrees) in Figure 6 than in Figure 5.

Thanks to the stiffness of the orthosis, the joints B and C of the thumb do not experience involuntary movements, for example during changes of hand orientation with respect to gravity, or linked to the laws of kinematics. This rigidity also allows reducing the amplitude and duration of involuntary movements such as reflex movements. On the other hand, the elasticity of the forming material of part 1 allows the orthosis not to hinder the voluntary movements of the thumb and, thus, avoid having to exert considerable additional efforts on the diseased joint during such voluntary movements. Thus, the user can grasp an object by hand exerting a minimum additional effort to compensate for the stiffness of the orthosis. It should be noted, in Figures 2 and 6, that the orthosis does not cover the fold zone between the thumb and the palm of the hand and, therefore, does not hinder the function of the hand clamp. Note also that the support effect conferred by the orthosis extends to the metacarpal-phalangeal joint C of the thumb, this joint may also suffer from osteoarthritis.

According to one embodiment, the material in which the piece 1 is formed is made with the contest of two layers of an elastic fabric, glued one on top of the other, by means of a layer of glue approximately 0.05 mm thick. The glue layer can be evenly distributed between the two layers of fabric, or arranged evenly distributed stitches. The two layers of fabric can be glued against each other by glueing one of the two layers and pressing the two layers against each other, by means of one or two rollers.

The fabric that forms the two layers can be a fabric based on polyamide (approximately 80% by weight) and elastane (approximately 20% by weight), with a weight of 155 g / m2. The glue used can be based on polyurethane. The set of material formed by the two thicknesses of fabric and the glue layer can have a weight of 355 g / m2. The forming fabric of the two layers can have a thickness between 0.5 and 0.7 mm. As a consequence, the material in which the piece 1 is formed can have a thickness between 1 and 1.4 mm. This fabric can have an elasticity between 85% and 115% in the direction of the warp and from 65% to 95% in the direction of the weft.

According to one embodiment, the orthosis comprises a damping element 5 which also has a certain intrinsic stiffness. The damping element 5 has an adapted shape and is arranged on the main part 1, in order to cover the carpal-metacarpal joints of the thumb. In Figures 2 to 4, the damping element is substantially in the shape of a crescent whose tips are truncated (Figure 8).

According to one embodiment, the damping element comprises a plate 5 of a material

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viscoelastic, such as a crosslinked polymer gel, for example a non-adhesive crosslinked silicone gel, which is fixed to the inner face of part 1.

Figure 7 represents a part of the orthosis in which the platelet 5 is fixed. As shown in Figure 7, the platelet 5 can be attached to a piece of tissue 52 that is fixed to the inner face of the part main 1 of the orthosis by seams 51, the platelet 5 being sandwiched between the main piece 1 and the piece of fabric 52. Figure 7 also shows the two layers 1a, 1b forming the main piece 1.

According to one embodiment, the main piece 1 can be made in a single piece 10a, some of whose edges are assembled to form the orthosis. Figure 8 represents part 10 in plane, comprising parts 2, 3, 4. Parts 2 and 4 have a substantially curved band shape, with a seam line 21, 41 at each end. The lines 21 are provided to be fixed to each other, to form the thumb sleeve 2. Similarly, the lines 41 are fixed to each other, to form the hand palm sleeve 4. Part 3 has a trapecial shape without a line sewing. Figure 8 also represents the platelet 5, the bulk of which is fixed on the part 4 and, the remaining parts, on the part 3, before the seams 21, 41.

Piece 10 can be used interchangeably to perform right hand and left hand orthoses. The hand to which the orthosis is intended is determined by the face on which the platelet 5 is fixed. Thus, the piece 10 shown in Figure 8 is intended to perform a left hand orthosis. The seams 21 and 41 are made by bending the piece 10 towards the outer face of the orthosis, in order to superimpose the lines 21 to form the sleeve 2, and to superimpose the lines 41 to form the sleeve 4.

Figures 9A and 9B represent curves C1, C2, C3, C4 illustrating the performance of the orthosis. Curves C1 to C4 show the variations as a function of the angle of the ABC formed by the carpal metacarpal joints of the thumb in a fall on a horizontal plane of the hand, relaxed muscles. Curves C1 and C3 correspond to a 5 cm drop and, curves C2 and C4, a 10 cm drop. Curves C1 and C2 in Figure 9A illustrate the case in which the hand does not carry an orthosis, and curves C3 and C4 in Figure 9B illustrate the case in which the hand carries the orthosis as represented in the figures. 2 to 4 and 6. According to curve C1, the angle ABC reaches a peak at 167 ° approximately as a result of the shock at the instant 0.22 s, and then oscillates between 154 ° and 161 ° in a damped manner. Following the curve c2, the angle ABC reaches a peak at approximately 173 ° as a result of the shock at the instant 0.25 s, and then oscillates between 150 ° and 162 ° in a damped manner. According to the curve c3, the peak reached by the angle ABC is limited to approximately 157 ° (instead of 163 °) as a result of the shock at the instant 0.21 s, and then oscillates between 148 ° and 152 ° in a way cushioned According to the C4 curve, the peak reached by the angle ABC is limited to approximately 158 ° (instead of 173 °) as a result of the shock at the instant 0.22 s, and then oscillates between 146 ° and 152 ° in a way cushioned Curves C1 to C4 show that the movements of the thumb around the MSA joint, resulting from the shock, have attenuated amplitudes thanks to the orthosis. It can also be observed that the oscillations resulting from the shock last less time with the orthosis.

It should be noted that these restraint and damping effects are obtained without the orthosis having to exert restraint forces, particularly at the junction between the wrist and the hand. It is therefore not necessary that the orthosis be adjusted exactly to the hand of each person to be relieved. Therefore, the orthosis can be manufactured in some standard sizes. In this way, three to five standard sizes can be contemplated, knowing that 80% of cases can be covered with only three standard sizes.

It will be clearly apparent to one skilled in the art that the present invention is susceptible to various embodiments and various applications. In particular, the invention is not limited to an orthosis comprising a damping plate. Indeed, the orthosis without the platelet perfectly performs the function of clamping the carpo-metacarpal joints of the thumb of the joint. Additionally, it can be observed that, although the oscillations observed in Figure 9B have lower amplitudes than in Figure 9A, these oscillations also last less time.

Nor is it necessary to form the main part 1 with the contest of two layers of elastic fabric glued together. Other materials can easily be found to give the main part 1 of the orthosis sufficient rigidity.

Nor is it necessary for the thumb cuff to cover the distal thumb joint. In fact, the support of the carpal-metacarpal joints is perfectly secured when the orthosis only covers the thumb to the middle of the proximal phalanx. For the rest, since the orthosis is only performed in standard sizes and not to size, the part of the thumb covered by the orthosis depends on the morphologies.

Claims (13)

5 10 fifteen twenty 25 30 35 40 1. Hand orthosis for holding the thumb, the orthosis comprising a main part (1) made of an elastic material and including: a first sleeve-shaped part (2) fitted to a part of the thumb that extends to the fold zone between the thumb and the palm of the hand, a second part (4) with the shape of a sleeve fitted to the wrist and a third part (3) that joins the first and second parts, configured to wrap an area of the hand that extends along the metacarpal of the thumb between the back and the palm of the hand, and that includes an opening (6) for the passage of the palm of the hand, characterized in that the second part (4) is assembled by means of a seam line to take the form of a sleeve, and the main part (1) is configured in order not to cover the fold zone between the thumb and the palm of the hand and is made of a material that has, in a direction corresponding to a longitudinal axis of the first part, a Young's module between 0.5 MPa and 1 MPa. 2. An orthosis according to claim 1, wherein the first part (2) is configured to cover the joint between the two phalanges of the thumb. 3. Orthosis according to one of claims 1 and 2, wherein the main part (1) comprises two layers (1a, 1b) of elastic fabric assembled by gluing. 4. Orthosis according to claim 3, wherein each of the two layers (1a, 1b) is made of a fabric comprising between 75 and 85% by weight of polyamide and between 15 and 25% by weight of elastane. 5. Orthosis according to one of claims 3 and 4, wherein each of the two layers (1a, 1b) has a weight of 155 g / m2 and / or a thickness between 0.5 and 0.7 mm. 6. Orthosis according to one of claims 3 to 5, wherein each of the two layers (1a, 1b) has an elasticity of 85% to 115% in the direction of the warp and 65% to 95% in the plot sense. 7. Orthosis according to one of claims 1 to 6, comprising a platelet (5) of a material capable of performing a damping function, the platelet being fixed inside the second (4) and third (3) parts, in an area that covers the joint between the thumb and wrist metacarpal. 8. An orthosis according to claim 7, wherein the platelet (5) is made of a crosslinked polymer gel. 9. An orthosis according to one of claims 7 and 8, wherein the platelet (5) has a thickness between 0.4 and 1 mm. 10. An orthosis according to one of claims 7 to 9, wherein the platelet (5) is glued onto a covering piece (52) of elastic fabric that is assembled with the main part (1) by means of a seam (51), so that the plate is sandwiched between the main piece and the cover piece. 11. An orthosis according to claim 10, wherein the platelet (5) is sewn with the cover piece (52) on the main piece (1). 12. An orthosis according to one of claims 1 to 11, wherein the main part is adjusted to the hand and the thumb to keep the thumb joints in a configuration of the hand in which all the muscles of the hand are relaxed and in the absence of external forces exerted on the thumb joints. 13. Orthosis according to one of claims 1 to 12, wherein the main part (1) is made of a material having a thickness between 1 mm and 1.4 mm.